Abstract:
BACKGROUND:A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fundamentals of laparoscopic surgery (FLS) than traditional practice volume metrics. METHODS:Twenty medical students were recruited to practice three FLS tasks: peg transfer, circle cut, and intracorporeal knot tie. Up to 7hours of self-directed practice was allotted to each participant. Practice attempts were scored by standard FLS criteria and monitored via Cusum. Each participant's terminal Cusum performance was analyzed retrospectively. Posttests were conducted by faculty blinded to practice performance. RESULTS:Eighteen participants completed the study (90%). Median adjusted posttest scores were 102.3, 84.1, and 78.6 for peg transfer, circle cut, and knot tie, respectively. For the knot tie task, participants who exceeded the Cusum decision interval during their final practice attempts performed significantly higher on posttesting (81.2 vs 71.5, p=0.015). Knot tie terminal Cusum score was positively associated with posttest performance after adjusting for practice volume (p=0.031). Total practice volume and practice time were not significantly associated with posttest performance for any FLS task. CONCLUSION:Cusum score is a more valid representation of FLS proficiency than practice volume or practice time. Incorporating Cusum in a clinical setting may promote more efficient allocation of time resources and operative volume.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Hu Y,Warren HL,McMurry TL,Goodrich RN,Choi J,Mahmutovic A,Kim H,Rasmussen SKdoi
10.1016/j.jpedsurg.2015.10.049subject
Has Abstractpub_date
2016-04-01 00:00:00pages
598-602issue
4eissn
0022-3468issn
1531-5037pii
S0022-3468(15)00660-0journal_volume
51pub_type
杂志文章abstract::In this case presentation of a 4-year-old boy with histopathologically proven Henoch-Schönlein purpura the authors report a surgical complication that occurred under corticosteroids; this had not been described previously. Relief of abdominal pain was dramatic and the hematemesis disappeared, but an entero-enteral fis...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90500-6
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Scintigraphy is considered the "gold standard" for investigating gastric emptying. The lack of standards regarding registration technique and meal composition has been a problem especially in pediatric patients. METHODS:In this study, gastric emptying of a solid meal was assessed by scintigraphy in 10 patie...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90091-4
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Advances in the management for biliary atresia (BA) have improved the prognosis and has greatly increased the number of long-term survivors. Even the long-term survivors, however, still face some problems. This retrospective review was performed to assess pregnancy-associated issues in long-term surv...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.03.027
更新日期:2007-08-01 00:00:00
abstract::End-to-end anastomosis has become the standard technique for repair of esophageal atresia with distal tracheoesophageal fistula. End-to-side anastomosis with ligation of the fistula in continuity has also been advocated. For over 25 years both methods have been used in this hospital. The purpose of this report is to c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90998-9
更新日期:1991-04-01 00:00:00
abstract::Perforated appendicitis in children continues to be associated with significant morbidity. In 1976, a treatment algorithm was begun at the authors' institution, which included immediate appendectomy, antibiotic irrigation of the peritoneal cavity, transperitoneal drainage through the wound, and 10-day treatment with i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90294-1
更新日期:1994-08-01 00:00:00
abstract::Mesenchymal hamartoma of the liver is the second most common benign liver tumor of childhood. Ultrasonography demonstrates a cystic lesion that may be very large. Computed tomographic scan will further establish the location and its relationship to vascular anatomy. Most will be amenable to gross total resection with ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.09.029
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Rhabdoid tumors (RTs) of the liver are rare, aggressive and nonsecreting malignancies occurring mainly during the first year of life. Definition of RT relies on characteristic morphology and on the inactivation of the SMARCB1 tumor suppressor gene. The aim of this study was to analyze clinical data, treatmen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.09.005
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the laparoscopic repair of isolated intestinal injuries in children who sustain focal abdominal trauma. METHODS:A retrospective review was conducted of all patients 16 years and younger who required surgery for traumatic bowel injuries during a 5-year period at 2 universit...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.06.049
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:Restrictions for ECMO in neonates include birth weight less than 2kg (BW <2kg) and/or gestational age less than 34weeks (GA <34weeks). We sought to describe their relationship on mortality. METHODS:Neonates with a primary diagnosis code of CDH were identified in the Extracorporeal Life Support Organ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.08.037
更新日期:2017-12-01 00:00:00
abstract::The authors used a conservative approach to treat focal nodular hyperplasia of the liver (FNH) and were interested in the long-term results of different therapeutic approaches in order to establish the most appropriate treatment. A review of the literature was conducted, and 31 pediatric case reports were identified i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(95)90162-0
更新日期:1995-11-01 00:00:00
abstract::Necrotizing fasciitis is a rapidly progressive soft tissue infection involving the skin, subcutaneous tissue, and superficial fascia. It is a rare entity in the pediatric population. The specific etiologic factors that contribute to the establishment of necrotizing fasciitis in children are not evident. It may occur a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.01.024
更新日期:2005-04-01 00:00:00
abstract::Previous criteria for primary reduction of the herniated viscera in newborn infants with gastroschisis included intraoperative respiratory rate, cardiac indices, degree of viscero-abdominal disproportion, size of defect, and lower extremity turgor. From 1976 through 1993, 129 neonates with gastroschisis were treated a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90016-0
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Multiple endocrine neoplasia 2A (MEN 2A) is a genetic syndrome manifesting as medullary thyroid carcinoma (MTC), hyperparathyroidism, and pheochromocytoma. Multiple endocrine neoplasia 2A results from mutations in the RET proto-oncogene. Hirschsprung disease (HSCR) is a rare manifestation of MEN 2A and has b...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.09.043
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Patients with repaired esophageal atresia often show persistent motility disorders of the esophagus. METHODS:In this study, the authors used a newly developed method, videomanometry, to study intraluminal pressures and function of the pharynx and upper esophagus in such a group of patients and compared the ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0022-3468(98)90154-3
更新日期:1998-08-01 00:00:00
abstract:PURPOSE:The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. MATERIALS AND METHODS:Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.09.066
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:The mechanism of fetal gastric dilation in gastroschisis is controversial. This study was designed to characterize changes in the contractile profile of strips of stomach from rats following experimental gastroschisis. METHODS:Pregnant Wistar rats were operated on day 18.5. Fetuses were divided into...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.11.011
更新日期:2013-02-01 00:00:00
abstract::The classic upside-down abdominal roentgenogram and the use of pelvic reference points have frequently been inaccurate in assessing the level of the distal pouch in patients with imperforate anus. The ultrasonic study described is different from that previously reported and allows more precise localization of the dist...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80268-7
更新日期:1979-12-01 00:00:00
abstract::We modified conventional hepatic portoenterostomy by pulling the remnant fibrous mass caudally and placing 5 or 6 numbered and individually clamped absorbable 5-0 double-needle sutures horizontally in the liver surface of the posterior side of the remnant fibrous mass before excision and apposing the posterior and ant...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.12.056
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Chronic infection of ingrown toenails may lead to exogenous osteomyelitis. Therefore, plain x-rays are commonly taken in children with significant inflammation. We evaluated the preoperative radiologic findings and their clinical significance, especially with regard to exogenic osteomyelitis. PATIENTS AND M...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.05.032
更新日期:2009-11-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate postoperative anal function of high-type imperforate anus after laparoscopically assisted anorectoplasty (LAARP). METHODS:Between 2000 and 2002, LAARP was performed in 13 patients with high-type imperforate anus. Clinical data of the LAARP group were compared with the post...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.08.008
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Biliary atresia (BA) is one of the most common and perplexing causes of neonatal cholestasis. Each year many cases of neonatal cholestasis are misdiagnosed as BA, resulting in unnecessary exploratory surgery. Therefore, the aim of our study was to analyze the clinical features and parameters that contribute ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.02.034
更新日期:2013-07-01 00:00:00
abstract::The neonatal piglet is a satisfactory model for the human neonate requiring total parenteral nutrition (TPN). Bile status and subsequent liver and gallbladder dysfunction have long been documented as serious complications of long-term TPN. The purpose of this study was to determine whether small amounts of enteral for...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80184-8
更新日期:1990-01-01 00:00:00
abstract::Legend holds that treating the hundreds of children injured in the Halifax explosion of December 6, 1917, compelled Dr. William E. Ladd (1880-1967) to dedicate his career to the surgical care of infants and children. However, he had made the commitment to be a pediatric surgeon several years before when he joined the ...
journal_title:Journal of pediatric surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.jpedsurg.2017.08.047
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:To evaluate the expression of Cold-inducible RNA-binding protein (CIRP) in torsion/detorsion of the testes in different phases and demonstrate the protective effect of CIRP on testicular injury after torsion/detorsion (T/D) in an experimental mouse model. METHODS:Twenty-four male BALB/c mice were divided rando...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.02.065
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:The purpose of this paper is to review the effect of intralesional corticosteroid therapy in the treatment of 155 head and neck hemangiomas. METHODS:In the past 10 years, we have treated 155 proliferating head and neck hemangiomas with intralesional corticosteroid injections. Three to 6 injections of triamcino...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90205-7
更新日期:2000-03-01 00:00:00
abstract::Small intestinal myoelectric activity has been studied extensively in adult humans and in many animal models. However, little is known about gut myoelectrical activity in newborns, a population susceptible to primary and secondary motility disorders. We report the development of a chronic neonatal piglet model for ass...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90075-k
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Ascending testes, which normally are located at the bottom of the scrotum in early infancy and later ascend back out of the scrotum, have been reported by several investigators. However, little is known about the effect of the division of the genitofemoral nerve (GFN) on testicular ascent as boys gro...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90206-3
更新日期:1999-02-01 00:00:00
abstract::The immunomodulator Corynebacterium parvum stimulates the reticuloendothelial system and causes splenic hypertrophy. The ability of C parvum to stimulate splenic regeneration in hemisplenectomized mice and decrease susceptibility to intranasal pneumococcal challenge was studied. Mice were divided into two groups, cont...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80375-9
更新日期:1984-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the frequency of thrombophilic disorders in children and adolescents with portal vein thrombosis (PVT) as well as assessing the hereditary character of this disorder. METHODS:A 2-year prospective study was carried out in pediatric PVT patients (n = 14), their parents (n =...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.05.005
更新日期:2004-09-01 00:00:00
abstract:AIM:The purpose of this study was to examine the efficacy of parathyroid autotransplantation in children undergoing total thyroidectomy. METHODS:We have prospectively evaluated 32 cases of total thyroidectomy in children. The ages ranged from 1 year to 15.7 years, and the mean was 8.9 years. In 31 cases, the indicatio...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90618-7
更新日期:1997-03-01 00:00:00